Early Childhood Caries, Masticatory Function, Child Early Cognitive, and Psychomotor Development: A Narrative Review.

Dental caries is known as a global public health issue that has been affecting general health apart from its painful nature. Hence, it is undeniable that caries affecting young children or known as early childhood caries, also have an effect on children's general health. One of the interesting findings about caries is that it can also affect child growth and development, specifically on their cognitive and psychomotor ability. Untreated caries are linked to cognitive development through both neural and vascular pathways, with masticatory function as the key. Meanwhile, its effect on psychomotor development might be related to nutritional intake, which might slightly decline on those with caries. This review is aimed to describe the current findings of caries effect on early child development, from masticatory disturbance to further impacts on cognitive and psychomotor development. The overall conclusion of this review is that untreated severe caries in children are potentially associated negatively with their growth and development.

Analysis of Saliva Composition: Parathyroid Hormone-Related Protein, Total Protein, and Secretory Immunoglobulin A (sIgA) in Rattus norvegicus with Stunted Growth.

OBJECTIVE: This study aimed to determine total protein, secretory immunoglobulin A (sIgA) and parathyroid hormone-related protein (PTHrP) levels in the saliva of rats with stunted growth. MATERIALS AND METHODS: Experimental laboratory research with a pre-and posttest control group design was conducted. Seventeen albino rats (Rattus norvegicus) were divided into the control group (eight rats) and the treatment group (nine rats). Rats in the treatment group were exposed to aflatoxin B1 5µg/kg orally for 5 weeks. Anthropometry data (body length, body weight) and saliva of R. norvegicus were collected. The levels of PTHrP and sIgA in the saliva were measured using an enzyme-linked immunosorbent assay kit for rats and the Bradford test for total protein and analyzed using SPSS 25.0. RESULTS: Aflatoxin caused stunted growth in rats in the treatment group. There was a significant difference in body length, salivary flow, PTHrP, sIgA, and total protein in the treatment group compared with the control group. The average rat's body length change in the control group was 6.4 ± 1.1mm/5 weeks, while in the treatment group, the change was 3.7 ± 0.9 mm /5 weeks. There was no significant weight gain in the treatment group compared with the normal group. The average values of PTHrP, sIgA, and total protein in the control group were x̄0.9, x̄18, and x̄0.7 m./L, respectively, while in the treatment group, they measured x̄0.4, x̄10.7, and x̄0.5 mg/L, respectively. CONCLUSION: This study showed that salivary flow, PTHrP, sIgA, and total protein levels in the saliva were significantly lower in stunted rats compared with normal rats.

Management of impacted maxillary central incisor and abnormality of labial frenulum in children: case report.

Deposition of the maxillary permanent central incisor is a rare occurrence in dental practice. It is a difficult condition to treat due to its importance to facial esthetics. If complications are to be avoided, early detection of such teeth is important. The present case report of impacted maxillary central incisor encased within an abnormally thickened labial frenulum. A 9-year-old boy, came with his parents to the Pediatric Dentistry Specialist, Dental and Oral Hospital, Airlangga University (UNAIR) with a chief complaint that his left maxillary front teeth did not grow while his right front teeth had grown perfectly. From the anamnesis, the patient had experienced a falling trauma when he was young, which caused the deciduous tooth to fall out. Good general health, no history of allergies, and no medical history of case management. This is a fixed orthodontic treatment with surgical exposure of impacted teeth and frenectomy of labial frenulum. After the crown of the impacted incisor was surgically exposed, eruption ball chain was bonded to traction the incisor. The left maxillary incisor fully erupted and normally to percussion, mobility, and sensitivity testing with good attached gingiva in the next 9 months. Management abnormality of labial frenulum in this case with frenectomy by using electrocautery for minimalized trauma in children. Fixed orthodontic therapy was continued to achieve proper alignment leading to good esthetic and functional rehabilitation. The treatment of an unerupted tooth will depend on its state, position, and presence of enough space in the dental arch to accommodate.

Oral Microbiome Profiles and Inflammation in Pregnant Women Who Used Orthodontic Appliances.

It is common for women to undergo orthodontic treatment during pregnancy, especially through the use of fixed orthodontic devices. In changing the oral microbiome profile, it is crucial to increase the immune responses of pregnant women using fixed orthodontics; however, changes in the microbiomes of pregnant women with orthodontic appliances can be adjusted. Therefore, we aimed to conduct research on the oral cavity microbiome profiles, specifically IL-6 and TNF-α, of pregnant women using fixed orthodontic appliances. We proposed an observational analysis of 30 third-trimester pregnant women. OHI-S was recorded, saliva collection was performed using the passive drool method for IL-6 and TNF-α, and analysis and mucosal swabs were used to determine the oral microbiome profile. Kruskal−Wallis and post hoc Bonferroni tests were used to identify any significant differences with values of p < 0.05. Of these pregnant women, those with orthodontic appliances developed 10 types of bacteria at similar levels (>80%) from the genera Streptococcus, Lactobacillus, and Veillonella. There was no difference between the oral microbiomes of the control group and the pregnant women with a history of orthodontic appliance use. While the level of TNF-α in the women with orthodontic appliances was higher compared with the control group who had never used orthodontic appliances (p < 0.05), there was no difference in the IL-6 levels. The IL-6 and microbiome profile produced normal results, so the use of orthodontic appliances during pregnancy should be allowed with conditions. Pregnant women with orthodontic appliances must keep the oral cavity clean and their appliances well-maintained to avoid oral problems.

Concanavalin A Enhanced Proliferation and Osteogenic Differentiation of Dental Pulp Stem Cells.

OBJECTIVE: Dental pulp stem cells (DPSCs) can be used as a component in the formation of regenerative dentine during direct pulp capping therapy. Concanavalin A (ConA) is a type of lectin with a molecular weight of 26 kDa derived from the Canavalia ensiformis plant. Lectins possess strong proliferation and differentiation abilities in various animal cells including lymphocytes, osteoblasts, and chondrocytes. The aim of study was to determine the effect of ConA on the proliferation and osteogenic differentiation of DPSCs in vitro. MATERIALS AND METHODS: In this in vitro study, DPSCs were isolated from third molars before ConA induction was performed at concentrations of 5 and 10 µg/mL. The proliferation assay was determined by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Osteogenic differentiation was determined by means of mineralization. STATISTICAL ANALYSIS: Data were analyzed using analysis of variance and a Student's t-test. The p-value was set at 0.05. RESULTS: The addition of 5 and 10 µg/mL of ConA to DPSCs can significantly increase the proliferation and osteogenic differentiation of DPSCs (p ≤0.05). CONCLUSION: ConA can increase the proliferation and osteogenic differentiation of DPSCs.

Prevalence of Caries and Periodontal Disease Among Indonesian Pregnant Women

Objective: To determine the extent of bleeding on probing, probing pocket depth and the level of oral hygiene and caries prevalence among pregnant women. Material and Methods: Random samples of pregnant women attending eight public health centers were examined. Their periodontal and caries statuses were examined using the Community Periodontal Index, Simplified Oral Hygiene Index and DMF-T. The good criteria of OHI-S ranged from 0 to 1.2, the fair from 1.3 to 3.0 and the poor from 3.1 to 6.0. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: 84.7% had caries and the DMF-T index score was 4.34 (fair). 73% suffered gingival bleeding, 34% with 4-5 mm pocket depth, 2% with 6 mm or deeper pocket depth, while the majority had good oral hygiene. The prevalence of 4-5 mm probing pocket depth increased between the first and second trimesters (12.1% to 48.5%), before undergoing a slight decrease in the third trimester (39.4%). Gingival bleeding was found to be most prevalent in the third trimester. Pocket depth of 4-5 mm was found to be highest in the second trimester. Pocket depth of 6 mm or more was restricted to the third trimester. Oral hygiene scores increased in tandem with gestational age. Conclusion: The majority had caries, which strongly suggests that the awareness of the pregnant women regarding their oral hygiene remains limited.

Effect of scaling and root planing on level of immunoglobulin E and immunoglobulin G4 in children with gingivitis and house-dust mite allergy: A pilot randomised controlled trial.

Background and Objective: There is a pressing need for developing innovative strategies to prevent allergic diseases among children. As house-dust mite (HDM) allergy is often seen in children with gingivitis, strategies should be derived from a conceptual framework of allergen elimination and pathogen eradication; one such strategy is dental scaling and root planing (SRP) to remove dental plaque and periodontal pathogens. The study aimed to evaluate the beneficial effects of comprehensive 6-months dental SRP to reduce the level of immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) in children with gingivitis and HDM allergy. IgE and IgG4, whose production is controlled mainly by Th-2 cells and B cells, are proven biomarkers for atopic inflammatory responses. Methods: The present study conducted a non-blinded randomised controlled trial with superiority design. A total of 10 subjects (age range 6-16 years) with gingivitis and positive skin-prick test to HDM from Pediatric Allergy Outpatient Clinic, Dr. Soetomo General Hospital were enrolled in the present study. Of the 10 subjects, only five received dental SRP. We further evaluated total serum IgE and IgG4 level before and 6 months after treatment. Results and Discussion: Subjects in the standard treatment group showed a slight decrease in the IgE level ([Formula: see text]) but no change in the IgG4 level ([Formula: see text]), while subjects in the intervention group showed a significant decrease in IgE ([Formula: see text]) and IgG4 levels ([Formula: see text]). Conclusion: The study results suggest that 6-month comprehensive dental scaling combined with root planing may help to reduce IgE and IgG4 levels in children with gingivitis and HDM allergy. Furthermore, untreated or undertreated gingivitis is often associated with worsening allergic manifestation and thus should be avoided. Trial Registration: ISRCTN31416107, retrospectively registered on 17 April 2018.

Converging findings from linkage between periodontal pathogen with atopic and allergic immune response.

This study aims to explore a relationship between exposures of whole-cell Porphyromonas gingivalis in various doses with atopic inflammatory responses at experimental mice. A pretest-posttest controlled group design, with 16 Wistar rats (Rattus novergicus) randomized into four groups. Group 1 was the control group. Group 2 was given low-dose (9 × 107 colony-forming unit) of P. gingivalis. Group 3 was given medium-dose (9 × 109 colony-forming unit) of P. gingivalis. Group 4 was given high-dose (9 × 1011 colony-forming unit) of P. gingivalis. Interleukin-4, Interleukin-5, Interleukin-17F, Interleukin-21, Immunoglobulin-E, Immunoglobulin-G4, and γ-Interferon were measured by direct-sandwich ELISA just before the treatments began, day-4, and day-11 after treatments. There is a sudden increase of Interleukin-4 in the group 4 (23.79 ±â€¯0.91 pg/ml to 54.17 ±â€¯0.79 pg/ml; p = 0.01) and slight increase of Interleukin-5 in the group 4 (207.60 ±â€¯11.15 pg/ml to 243.40 ±â€¯9.33 pg/ml; p = 0.03). No change was observed for Interleukin-17F in all groups. Serum concentration of Immunoglobulin-E was decreased in group 2 (-10.44 ±â€¯8.13 pg/ml), but increased in group 4 (+1.03 ±â€¯4.57 pg/ml). Taken together, some cytokines are up-regulated and others are down-regulated after exposure to whole-cell P. gingivalis. Moreover, study of host responses during periodontal infection may offer critical key insight that contribute to the development of atopy. CLINICAL IMPLICATIONS: We introduced and explained the potential role of periodontal pathogen Porphyromonas gingivalis in systemic immune responses, along with its virulence factor inside the oral cavity. Our results consider several changes and differences of cytokines and immunoglobulins following whole-cell Porphyromonas gingivalis exposure. However, results of the study need to be interpreted with caution due to its limitations. CAPSULE SUMMARY: Interleukin (IL)-4 and IL-5 had been found increase after exposure to the periodontal pathogens Porphyromonas gingivalis, whereas no or minimal change had been found in the level of IL-17F, Ig-G4, and IFN-γ. The various cytokines and immunoglobulins shown in this study do not prove a causal relationship, and the precise role of Porphyromonas gingivalis in the regulation of atopic immune response warrants further investigation. Nevertheless, these findings may provide some critical key insight into the host responses following Porphyromonas gingivalis infection.

Initial acquisition and transmission of mutans streptococci in children at day nursery.

The purposes of this study were to determine the age at the initial acquisition of mutans streptococci (MS) and to determine the transmission of MS among children at day nursery by describing the occurrence of genotypes prepared by chromosomal DNA fingerprinting of the bacteria using restriction endonuclease EcoRI and HaeIII. The samples were 39 children (23 boys and 16 girls) aged 0-5 years old, 14 pairs of parents and 6 nursery caretakers of a day nursery in Hiroshima city, Japan. The children had no dental caries throughout the experiment. Plaque samples of the children were taken using toothbrushes at 1 month intervals for 30 months. The initial acquisition of MS occurred between the ages of 8 months and 52 months with a mean age of 24.2 months. The cumulative probability of initial acquisition of MS increased rapidly at the age of 12 to 25 months after 10 to 20 primary teeth had erupted. Transmission of MS was found between child and mother (33.3%), child and father (8.3%) and child and others including amongst the children (58.4%), but no evidence of MS transmission from nursery caretakers was found. Two children acquired MS from intra- and extra-familial transmission. This study suggests that the child's environment also plays a role in the initial acquisition and transmission of MS, in addition to the oral condition of the children.